CONCEPT ANALYSIS OF CULTURAL COMPETENCE

Concept Analysis of Cultural Competence

Concept Analysis of Cultural Competence

Introduction

Health care providers may have preconceived and even erroneous perceptions of people living in rural areas regarding their lifestyles, health habits, and culture. Although there are some concepts considered to be central to rural people as a whole, the culture of rural areas may vary widely from region to region. Since rural culture can be manifested in many ways and often differs by setting, nursing educators need to consider broadening the perspective of students to a variety of cultural settings in an effort to increase rural cultural competency. The purpose of this article is to describe the collaborative relationship and the unique curricular design of a practicum in which students visited a rural community quite different from their own. They conducted a community assessment, assisted on a community health teaching project, and immersed themselves in a rural community in a coal mining area of West Virginia in order to build cultural competence. This project allowed students to discover for themselves the distinctions of rural life in a unique locale.

Literature Review

Providing high quality health care and assisting people to change behaviors and understand the benefits of health living is fundamental to nursing practice. Cultural misunderstandings and miscommunications may form obstacles that thwart the level of nursing services provided (National Alliance for Hispanic Health, 2001). Rural America is diverse with varying populations, geographies, economies, and ethnicities. Appalachia is a predominantly rural and diverse region within the United States. As a population of health interest, many Appalachian people exceed other Americans in years per life lost on many national health indicators (Health Risks, 1995). Culturally, Appalachian people have been portrayed throughout the twentieth century as a static, homogenous, white mountain culture (Reel, 2002; Newell-Withrow, 1997). However, Appalachia traverses a broad stretch of land from New York to northern Mississippi with diverse geographies, economies, and people (Appalachian Regional Commission, 2002).

While rurality is diverse, one of the challenges to understanding any culture, including rural ones, is recognition that human societies tend to develop ethnocentrism—the viewing of one's own cultural standards as the true universal and the judging of other cultures by one's own standards (National Alliance for Hispanic Health, 2001). Culturally immersed clinical experiences promoted opportunities for transforming static perspectives about rural Appalachia in West Virginia and rural New York. For example, the target county for cultural immersion experiences is located in the Southern West Virginia coalfields. Rural life in this county is dominated by the coal industry and changes affiliated with this industry, and differs considerably from the predominantly farming rural areas with which nursing students at Binghamton University are familiar. The educational exchange between Binghamton University and Marshall University relied on immersion as a strategy to expand student's realities of rural diversity as well as to dispel negative connotations historically associated with Appalachian people.

Myths about rural lifestyles are common among Americans. The picture of a pastoral life, healthy eating, and fresh air is promoted from early childhood books to ...